1. Serious Bacterial Infections in Young Febrile Infants With Positive Urinalysis Results.
- Author
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Cruz, Andrea, Vitale, Melissa, Powell, Elizabeth, Leetch, Aaron, Pickett, Michelle, Brayer, Anne, Nigrovic, Lise, Dayan, Peter, Atabaki, Shireen, Ruddy, Richard, Rogers, Alexander, Greenberg, Richard, Alpern, Elizabeth, Tunik, Michael, Saunders, Mary, Muenzer, Jared, Levine, Deborah, Hoyle, John, Lillis, Kathleen, Gattu, Rajender, Crain, Ellen, Borgialli, Dominic, Bonsu, Bema, Blumberg, Stephen, Anders, Jennifer, Roosevelt, Genie, Browne, Lorin, Cohen, Daniel, Linakis, James, Jaffe, David, Bennett, Jonathan, Schnadower, David, Park, Grace, Mistry, Rakesh, Glissmeyer, Eric, Cator, Allison, Bogie, Amanda, Quayle, Kimberly, Ellison, Angela, Balamuth, Fran, Richards, Rachel, Ramilo, Octavio, Mahajan, Prashant, VanBuren, John, Kuppermann, Nathan, and Tzimenatos, Leah
- Subjects
Bacteremia ,Bacterial Infections ,Child ,Fever ,Humans ,Infant ,Meningitis ,Bacterial ,Procalcitonin ,Urinalysis ,Urinary Tract Infections - Abstract
UNLABELLED: It is unknown whether febrile infants 29 to 60 days old with positive urinalysis results require routine lumbar punctures for evaluation of bacterial meningitis. OBJECTIVE: To determine the prevalence of bacteremia and/or bacterial meningitis in febrile infants ≤60 days of age with positive urinalysis (UA) results. METHODS: Secondary analysis of a prospective observational study of noncritical febrile infants ≤60 days between 2011 and 2019 conducted in the Pediatric Emergency Care Applied Research Network emergency departments. Participants had temperatures ≥38°C and were evaluated with blood cultures and had UAs available for analysis. We report the prevalence of bacteremia and bacterial meningitis in those with and without positive UA results. RESULTS: Among 7180 infants, 1090 (15.2%) had positive UA results. The risk of bacteremia was higher in those with positive versus negative UA results (63/1090 [5.8%] vs 69/6090 [1.1%], difference 4.7% [3.3% to 6.1%]). There was no difference in the prevalence of bacterial meningitis in infants ≤28 days of age with positive versus negative UA results (∼1% in both groups). However, among 697 infants aged 29 to 60 days with positive UA results, there were no cases of bacterial meningitis in comparison to 9 of 4153 with negative UA results (0.2%, difference -0.2% [-0.4% to -0.1%]). In addition, there were no cases of bacteremia and/or bacterial meningitis in the 148 infants ≤60 days of age with positive UA results who had the Pediatric Emergency Care Applied Research Network low-risk blood thresholds of absolute neutrophil count
- Published
- 2022